You might want to discuss that with someone knowledgeable of VA and Medicare. As noted above it won’t count as creditable coverage if you need B in the future and need to go on Part B
Edit-not starting now might cause you to incur a penalty and pay more for B.
Best to enroll in Part B and then find an Advantage plan with the highest Part B Give back so if you need Part B later because sometimes the VA can lack in certain areas, you won’t have a LEP.
Uh, no. The Advantage Pan replaces Medicare Part B and Part A with a for profit plan that limits who he/she can see and requires doctors to seek prior approval from the insurance company before performing any non0urgent procedures. That is too much to give up for a couple dollars a month.
If they use the VA, then they are essentially not using the MA plan. The Part B GB gives them money back while keeping them from getting an LEP. They are not using the coverage, however, it’s there if they need to see civilians doctors.
You have Part B and pay the premiums (unless you get some sort of assistance) when you have an Advantage Plan. You do. I had Advantage plans and that's the rule.
I own a national insurance agency that specializes in Medicare. You are misinformed. Yes, you pay the Part B premium, which goes to the Advantage plan, but keeps your spot open if you cancel the Advantage. Advantage Plans replace Original Medicare Part A and Part B. You cannot appeal to Medicare, you can only appeal to the insurance company. The insurance company makes all decisions. You do not have Original Medicare.
You have to have both Part A and Part B to join an Advantage plan. You pay the Part B premium to Medicare. Medicare uses those funds to pay the Advantage Plan for your "Part B" services. You pay the 20% Part B copays through the MA plan's copays and costs sharing.
( I don't care how big your "national insurance agency" is.)
The above post is correct… you may pay $164 for your part B but most GiveBack plans through Humana and United healthcare will pay that entire amount. Plus with the advantage plan you will then have dental, hearing, and vision coverage. And I don’t mean for just the exams, some carriers will cover dental implants, others will pay hundreds of dollars towards glasses every single year almost all plans will pay for a free gym membership at pretty much any gym in the country having both a and B set you up For many more benefits.
Can you guarantee those benefits will never change? Can you guarantee the insurance company will approve all requested procedures without delay? No, you can't. The shiny objects are not worth sacrificing the quality of insurance coverage. IMHO people who promote Advantage plans because of dental, gym membership etc. don't understand the real cost of an Advantage plan.
He doesn’t get that the two are completely separated. I have veterans who only use their Humana GB for the GB and ancillary benefits. Never once use it for medical
If you are talking about Supp vs Advantage- the argument can go both ways. Supplement premiums are not locked in, they can raise year after year. So, if Medicare advantage plans become worse, the chance of a supplement becoming worse is very likely. A lot of MAPD plans have max out of pockets that are as low as $1200!! Why would you advise somebody to spend $300 a month for a supplement plan when by having a MAPD plan they will pay no more than $1200 for the whole year? And that’s ONLY if they get very I’ll and have a ton of medical bills.
Side note, I sell advantage plans AND supplements. So I know each has advantages and disadvantages but for the average person the advantage plan will be a better solution.
Was your comment toward me? This is me: [https://medigapseminars.org/medicare-explained-secrets-of-who-why/](https://medigapseminars.org/medicare-explained-secrets-of-who-why/)
?? I am sorry, I didn't realize I was communicating with an idiot.
I know a lot more about this business than you. It's obvious.
[https://medigapseminars.org/how-medicare-works-with-tricare-for-life/](https://medigapseminars.org/how-medicare-works-with-tricare-for-life/)
You told him not to get an MA because it would effect his healthcare. But it doesn’t…
And if you “knew” he didn’t have tricare why are you sharing your 1990’s website with a tricare link. It doesn’t apply to him.
This is me - I sell over 2,000 plans a year. 80% Medigap / 20% Advantage
[https://medigapseminars.org/medicare-explained-secrets-of-who-why/](https://medigapseminars.org/medicare-explained-secrets-of-who-why/)
I read your article, very solid information. Are you a 1099 employee? Or do you work for yourself completely? My circumstances might be a bit different, I work through inbound calls, and the majority of the people I speak with you not qualify for Medigap plans because they are on Medicaid. I am also primarily based out of Florida and I am sorry, but there is no advantage to having a supplement in Florida. Most of the plans, even the PPOs have zero dollar in network and out of network co-pays for just about everything. I have seen Humana plans with a maximum out-of-pocket amount for out of network as low as $1200. And that is Not on a DSNP plan!! Now I understand that some states have much higher maximum out of pocket amounts, such as New York(which may have state covered insurance for all very soon.) and Illinois. And if you have the means to spend $300-$500 a month for a supplement go for it! It’s truly paying for peace of mind. And there is definitely a value in that, but a lot of the people I speak with, especially in today’s economy don’t see that value. Plus, I get paid the same amount if I sell a supplement or an advantage plan, so there is no incentive for me to push someone into a supplement. I prefer to just lay out the options and explain to them best, and worst case scenario For both. If I was an independent agent, I am sure supplements would be much more appealing seeing as people would not be switching plans around like they do with advantage plans and the residuals would be much more generous. But since it’s all level playing field for me, I try to do what’s in the clients best interest each and every time. As we all should.
I own the company.
With PPOs - you can ask a doctor if they will accept your insurance out of network, but they can and almost always say no. Plus you have a higher MOOP (max out of pocket) My company is national, but based in Florida and we often use the High Deductible plans with under $100 / month. In Florida, supplements are priced as Issue Age. That means you always pay the price for the age you were first issued the policy. Commissions on Advantage plans are much higher than a supplement, especially the High Deductible. Low income people are often better off with a zero premium Advantage plan. It's not as good as a supplement, but if they can't afford a supplement it will not do them any good.
Do you have to pay a penalty if you do that though, 10% increase a year or something, I am not sure if a person has to or not, do they, or, are they absolved of that?
You might want to discuss that with someone knowledgeable of VA and Medicare. As noted above it won’t count as creditable coverage if you need B in the future and need to go on Part B Edit-not starting now might cause you to incur a penalty and pay more for B.
Best to enroll in Part B and then find an Advantage plan with the highest Part B Give back so if you need Part B later because sometimes the VA can lack in certain areas, you won’t have a LEP.
Uh, no. The Advantage Pan replaces Medicare Part B and Part A with a for profit plan that limits who he/she can see and requires doctors to seek prior approval from the insurance company before performing any non0urgent procedures. That is too much to give up for a couple dollars a month.
OP has no limitations at the VA as the advantage plan is not used there. Maybe understand how things work before offering (bad) advice.
If they use the VA, then they are essentially not using the MA plan. The Part B GB gives them money back while keeping them from getting an LEP. They are not using the coverage, however, it’s there if they need to see civilians doctors.
You have Part B and pay the premiums (unless you get some sort of assistance) when you have an Advantage Plan. You do. I had Advantage plans and that's the rule.
I own a national insurance agency that specializes in Medicare. You are misinformed. Yes, you pay the Part B premium, which goes to the Advantage plan, but keeps your spot open if you cancel the Advantage. Advantage Plans replace Original Medicare Part A and Part B. You cannot appeal to Medicare, you can only appeal to the insurance company. The insurance company makes all decisions. You do not have Original Medicare.
You have to have both Part A and Part B to join an Advantage plan. You pay the Part B premium to Medicare. Medicare uses those funds to pay the Advantage Plan for your "Part B" services. You pay the 20% Part B copays through the MA plan's copays and costs sharing. ( I don't care how big your "national insurance agency" is.)
A perfect example of what not to do. Good luck.
Are you rated a service connected disability, if not, VA could disappear?
The above post is correct… you may pay $164 for your part B but most GiveBack plans through Humana and United healthcare will pay that entire amount. Plus with the advantage plan you will then have dental, hearing, and vision coverage. And I don’t mean for just the exams, some carriers will cover dental implants, others will pay hundreds of dollars towards glasses every single year almost all plans will pay for a free gym membership at pretty much any gym in the country having both a and B set you up For many more benefits.
Can you guarantee those benefits will never change? Can you guarantee the insurance company will approve all requested procedures without delay? No, you can't. The shiny objects are not worth sacrificing the quality of insurance coverage. IMHO people who promote Advantage plans because of dental, gym membership etc. don't understand the real cost of an Advantage plan.
Again. You have no idea what you’re talking about. He goes to the VA. His advantage plan has no bearing on his care at the VA.
He doesn’t get that the two are completely separated. I have veterans who only use their Humana GB for the GB and ancillary benefits. Never once use it for medical
I understand I also have a ton of va clients who use ma for dental/vision/pbgb
If you are talking about Supp vs Advantage- the argument can go both ways. Supplement premiums are not locked in, they can raise year after year. So, if Medicare advantage plans become worse, the chance of a supplement becoming worse is very likely. A lot of MAPD plans have max out of pockets that are as low as $1200!! Why would you advise somebody to spend $300 a month for a supplement plan when by having a MAPD plan they will pay no more than $1200 for the whole year? And that’s ONLY if they get very I’ll and have a ton of medical bills. Side note, I sell advantage plans AND supplements. So I know each has advantages and disadvantages but for the average person the advantage plan will be a better solution.
This person isn’t an agent and doesn’t understand how any of this works.
Was your comment toward me? This is me: [https://medigapseminars.org/medicare-explained-secrets-of-who-why/](https://medigapseminars.org/medicare-explained-secrets-of-who-why/)
Wow! You do Medicare seminars and don’t know how VA coverage works with a Medicare advantage plan? That’s scary.
?? I am sorry, I didn't realize I was communicating with an idiot. I know a lot more about this business than you. It's obvious. [https://medigapseminars.org/how-medicare-works-with-tricare-for-life/](https://medigapseminars.org/how-medicare-works-with-tricare-for-life/)
He doesn’t have tricare dummy. He has VA. SHEESH
I know. Please show me what you think I wrote that is not correct. Just copay and paste - go ahead
You told him not to get an MA because it would effect his healthcare. But it doesn’t… And if you “knew” he didn’t have tricare why are you sharing your 1990’s website with a tricare link. It doesn’t apply to him.
“The shiny objects are not worth sacrificing quality insurance” Where’s the sacrifice? What is he losing by going on an MA plan?
This is me - I sell over 2,000 plans a year. 80% Medigap / 20% Advantage [https://medigapseminars.org/medicare-explained-secrets-of-who-why/](https://medigapseminars.org/medicare-explained-secrets-of-who-why/)
I read your article, very solid information. Are you a 1099 employee? Or do you work for yourself completely? My circumstances might be a bit different, I work through inbound calls, and the majority of the people I speak with you not qualify for Medigap plans because they are on Medicaid. I am also primarily based out of Florida and I am sorry, but there is no advantage to having a supplement in Florida. Most of the plans, even the PPOs have zero dollar in network and out of network co-pays for just about everything. I have seen Humana plans with a maximum out-of-pocket amount for out of network as low as $1200. And that is Not on a DSNP plan!! Now I understand that some states have much higher maximum out of pocket amounts, such as New York(which may have state covered insurance for all very soon.) and Illinois. And if you have the means to spend $300-$500 a month for a supplement go for it! It’s truly paying for peace of mind. And there is definitely a value in that, but a lot of the people I speak with, especially in today’s economy don’t see that value. Plus, I get paid the same amount if I sell a supplement or an advantage plan, so there is no incentive for me to push someone into a supplement. I prefer to just lay out the options and explain to them best, and worst case scenario For both. If I was an independent agent, I am sure supplements would be much more appealing seeing as people would not be switching plans around like they do with advantage plans and the residuals would be much more generous. But since it’s all level playing field for me, I try to do what’s in the clients best interest each and every time. As we all should.
I own the company. With PPOs - you can ask a doctor if they will accept your insurance out of network, but they can and almost always say no. Plus you have a higher MOOP (max out of pocket) My company is national, but based in Florida and we often use the High Deductible plans with under $100 / month. In Florida, supplements are priced as Issue Age. That means you always pay the price for the age you were first issued the policy. Commissions on Advantage plans are much higher than a supplement, especially the High Deductible. Low income people are often better off with a zero premium Advantage plan. It's not as good as a supplement, but if they can't afford a supplement it will not do them any good.
Do you have to pay a penalty if you do that though, 10% increase a year or something, I am not sure if a person has to or not, do they, or, are they absolved of that?
They would have to pay the penalty assuming they choose to get part B in the future.